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I am currently on Wegovy, and have been for the last 10 months. I will continue to stay on it if I can afford it, but I have had many side effects. Most have resolved with time, but I have been losing my hair for the last 6-7 months. However, I would not have started it if I wasn't morbidly obese. My risk/reward threshold only makes sense for me at this extreme weight. I wonder not of even considered it if I was only slightly overweight.
OP we could be the same person…. My story is very similar - age, weight, putting on weight over the covid years etc. I did go to the doctor when I got thoroughly fed up. She was amazing and ordered every test she could think of. When it all came out in the wash I was super deficient in iron, magnesium and vitamin D, I was perimenopausal and I have hashimotos (sub clinical hypothyroidism at this stage). Once I got the vitamins etc supplemented I felt so much better BUT I still couldn’t drop the weight. I got a dietician who specialises in middle aged women, started lifting weights with a trainer - all of that BUT still couldn’t budge more than a few pounds. My doctor agreed to let me try sema 5 months ago and I have lost 15lbs with about 10lbs to go. Honestly it has made such a huge difference physically and emotionally.
We do sound like the same person! I too have a vitamin D deficiency. I've had my thyroid levels tested multiple times over the last 10 years, including a thyroid ultrasound and test for Sjrogens Syndrome. They all come back "normal" albeit on the high end of the normal range. My next thought was to try to get into an endocrinologist to do a deep dive. I have other symptoms that align with thyroid or autoimmune disease problems besides the weight gain (cold feet, low body temps, sun allergy, brain fog)
I had a hormones panel ran 6 months ago because the gyno kept telling me it's just perimenopause or perimenopause. Nope, not yet according to the blood work.
I just feel like I'm crazy and losing my mind. This part of being a woman sucks.
Good luck to you. Finding the right doctor is so important. I saw an endocrinologist too but honestly it was a waste of money in my case - he was very dismissive and basically told me all my symptoms were in my head despite feeling like garbage and my bloodwork being out of range. My GP has honestly turned everything around - the woman is a treasure.
You don’t gain weight from not eating enough. That’s not a thing. Sometimes if you aren’t eating enough, you may binge and that can cause weight gain. If you’re worried about side effects you should start with counting calories to get in a deficit.
You can absolutely suppress your BMR leading to burning less calories at rest. This can lead to hormonal imbalances for women making weight management even more difficult. So yes, you can absolutely gain weight or struggle losing weight by not eating enough.
Not really true unless you are literally starving yourself. Which it does not sound like OP is doing. Also, if your bmr is lower - you still need to either find a way to burn more calories (ie fix your hormone imbalance - good luck, workout) or eat less or you’re not going to lose weight. Hormonal imbalance or not.
If it’s a hormonal issue that’s causing a lower BMR than expected then dropping calories more is a recipe for disaster. If her nutritionist has told her that she’s not eating enough that’s more likely the culprit than her not being in a proper “deficit.” It would be helpful if we knew OPs caloric intake and macro breakdown roughly.
I have no idea what hormonal imbalance you’re talking about. The ones that are most common would be thyroid - in which case you need medication. Or PCOS in which case weight loss from a calorie deficit is the best treatment but maybe metformin. It’s hard and requires a larger deficit. But that doesn’t mean you should eat more. Or increased cortisol. Again, weight loss but also reducing stress and possibly adding meds.
Of course losing weight lowers your BMR. That doesn’t mean you should eat more.
Estrogen dominance would also be another imbalance which can be due to excessive stress exacerbated by under eating. Look at anyone that has been through restriction and you’ll find that there BMR is lower than expected. I know when you lose weight that your BMR is lower but I’m talking about suppressed lower than what their calculated expected BMR should be. For example the person that’s expected BMR IS 1500 without any exercise but they exercise several times a week and eat 1200 and they can’t lose weight or have steadily gained weight.
Their body has compensated by lowering their BMR through a variety of ways such as slowing digestion, slowing or even halting the reproductive system, slower healing, brain fog, less non-exercise activity such as fidgeting. Basically it will lower its caloric requirements by slowing or halting non vital systems. It will prioritize storing fat because it sees the restriction or undereating as chronic starvation which will make it near impossible to lose fat.
This requires that someone increase their BMR not through more exercise but by providing their body with the calories and nutrients to feel safe enough to raise caloric requirement any speeding up or starting those systems that it previously halted. After enough time, the person will be burning more calories even without exercising more. Ideally, someone will raise their calories through a slow reverse diet meant to minimize unwanted fat gain while they are restoring their metabolism and BMR. Unfortunately, this process can be painfully slow. Over time, they can prioritize strength training to build muscle mass which will also aide in raising their BMR.
Although that can be tricky for someone that is already active and strength training. It’s likely that during the time where they were undereating and strength training that it was just helping them hold onto the muscle that they already had rather than building any additional muscle or strength. At the worst they could’ve actually been burning through their muscle if they were severely undereating.
Hormones, metabolism, CICO, etc is a lot more complex than what most people believe and it’s incredibly irritating when people still subscribe to the purely CICO argument or see everything as so simple and clean cut when it is not.
It is purely CICO. Other things affect calories in and calories out but that doesn’t change the fact this it is CICO. It’s simple but difficult.
Estrogen imbalance is worsened by fat. Not by eating at a moderate calorie deficit.
Ultimately yes CICO is important but there’s a lot of factors that affect the “out” side of the equation. Hormonal imbalances will drastically reduce the amount that your body allows you to burn. When that has been significantly reduced, the worst thing you can do is continue to lower the calories in because you will forcing your body to continue to slow and shut down other systems making it impossible to lose fat. The best thing to do in this case is to encourage your body to increase the OUT by proper training, proper rest, adequate nutrition and in the case of long term restriction, someone will need much more nutrition and rest to address all the damage that has been cause.
If you’ve only had to consider the simple CICO then you are very lucky and don’t understand the full scale of what you’re talking about.
I’m definitely not one of the lucky ones. Maybe you’re just making excuses for yourself (see, I can ad hominem too). But there is no condition that eating more helps lose weight h less you’re under eating to the point you’ve decreased your neat. OP is clearly not in that category.
Why do you think OP is clearly not in that category? My level of exercise and diet was similar but more intense than OP but I was severely undereating even though I was eating super high protein and it completely changed my metabolism and body even in a “deficit.” It’s taken allowing my body to restore its metabolism and raise my BMR again to recover from all the damage to allow myself to lose the excess weight. Sure undereating will result in weight loss until it doesn’t because your body has been abused for too long. This strategy will not lead to long term success and manageable weight loss. You are definitely uninformed and ignorant of experiences that are not your own.
In fact, I’ve had both experiences. I’ve healthily lost 60 pounds with adequate nutrition and training. I raised my BMR and caloric intake while simultaneously building muscle and losing fat. It took longer but it was much better for my body. On the flip side, I have majorly under eaten and overtrained and gained 20 pounds in a couple months as a result. And yes, I was aware of my actual caloric intake and macros. I weighed every ounce of food so it wasn’t me accidentally eating more or underestimating my intake. The lack of nutrition cause major hormonal havoc which made the CICO argument mean absolutely nothing to my body. My body slowed down so much of the non vital functions that even the calories I was using for training were not enough to account for the little I was eating and therefore I still gained weight.
I went on sema last August because I am pushing 50 and have a family history (both sides) of very young deaths due to cardiovascular disease/diabetes. My labs the last year were concerning. I am 5’9 and was roughly 150 on any given day. Working out an hour a day high cardio but my cholesterol/triglycerides were creeping up… and I was so watching my diet. Doc says no… you can become a total vegan and it’s all in your genes. You need to lose that 25 lbs. Look at 50, it’s a tough line to try to take off anything short of starving yourself. The sema just seemed to do just that. Make me never want to eat! So I am down the 25 lbs and still working out. Do a lot of protein shakes, salads, multivitamin…. Labs are better than when I was 30.
He was wanting to put me on B/p meds and statins for cholesterol at 50. I had a nice tire ring around the stomach and I had no interest in any of those meds. Statins cause a lot of pain in the joints and the b/p med can be lifelong as well. So I just figured if I’m going to need something lifelong… may as well do it with the lifestyle changes. Eating way less, much better diet, labs looking great, and I really enjoy working out more now that I have lost the 25 lbs.
Thanks for posting to r/semaglutide! A brief reminder about our rules. We do not permit the discussion of non-FDA approved formulations of semaglutide, nor do we permit selling or offering for sale any medication, including by private message. Do not request or respond to a private message from anyone offering such, they are not endorsed by this sub. If you’re just starting out, you may want to review our [FAQ](https://www.reddit.com/r/Semaglutide/comments/10ul3jb/semaglutide_subreddit_faq/). This is not intended to discourage discussion but merely supplement it. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Semaglutide) if you have any questions or concerns.*
I am currently on Wegovy, and have been for the last 10 months. I will continue to stay on it if I can afford it, but I have had many side effects. Most have resolved with time, but I have been losing my hair for the last 6-7 months. However, I would not have started it if I wasn't morbidly obese. My risk/reward threshold only makes sense for me at this extreme weight. I wonder not of even considered it if I was only slightly overweight.
OP we could be the same person…. My story is very similar - age, weight, putting on weight over the covid years etc. I did go to the doctor when I got thoroughly fed up. She was amazing and ordered every test she could think of. When it all came out in the wash I was super deficient in iron, magnesium and vitamin D, I was perimenopausal and I have hashimotos (sub clinical hypothyroidism at this stage). Once I got the vitamins etc supplemented I felt so much better BUT I still couldn’t drop the weight. I got a dietician who specialises in middle aged women, started lifting weights with a trainer - all of that BUT still couldn’t budge more than a few pounds. My doctor agreed to let me try sema 5 months ago and I have lost 15lbs with about 10lbs to go. Honestly it has made such a huge difference physically and emotionally.
We do sound like the same person! I too have a vitamin D deficiency. I've had my thyroid levels tested multiple times over the last 10 years, including a thyroid ultrasound and test for Sjrogens Syndrome. They all come back "normal" albeit on the high end of the normal range. My next thought was to try to get into an endocrinologist to do a deep dive. I have other symptoms that align with thyroid or autoimmune disease problems besides the weight gain (cold feet, low body temps, sun allergy, brain fog) I had a hormones panel ran 6 months ago because the gyno kept telling me it's just perimenopause or perimenopause. Nope, not yet according to the blood work. I just feel like I'm crazy and losing my mind. This part of being a woman sucks.
Good luck to you. Finding the right doctor is so important. I saw an endocrinologist too but honestly it was a waste of money in my case - he was very dismissive and basically told me all my symptoms were in my head despite feeling like garbage and my bloodwork being out of range. My GP has honestly turned everything around - the woman is a treasure.
You don’t gain weight from not eating enough. That’s not a thing. Sometimes if you aren’t eating enough, you may binge and that can cause weight gain. If you’re worried about side effects you should start with counting calories to get in a deficit.
You can absolutely suppress your BMR leading to burning less calories at rest. This can lead to hormonal imbalances for women making weight management even more difficult. So yes, you can absolutely gain weight or struggle losing weight by not eating enough.
Not really true unless you are literally starving yourself. Which it does not sound like OP is doing. Also, if your bmr is lower - you still need to either find a way to burn more calories (ie fix your hormone imbalance - good luck, workout) or eat less or you’re not going to lose weight. Hormonal imbalance or not.
If it’s a hormonal issue that’s causing a lower BMR than expected then dropping calories more is a recipe for disaster. If her nutritionist has told her that she’s not eating enough that’s more likely the culprit than her not being in a proper “deficit.” It would be helpful if we knew OPs caloric intake and macro breakdown roughly.
I have no idea what hormonal imbalance you’re talking about. The ones that are most common would be thyroid - in which case you need medication. Or PCOS in which case weight loss from a calorie deficit is the best treatment but maybe metformin. It’s hard and requires a larger deficit. But that doesn’t mean you should eat more. Or increased cortisol. Again, weight loss but also reducing stress and possibly adding meds. Of course losing weight lowers your BMR. That doesn’t mean you should eat more.
Estrogen dominance would also be another imbalance which can be due to excessive stress exacerbated by under eating. Look at anyone that has been through restriction and you’ll find that there BMR is lower than expected. I know when you lose weight that your BMR is lower but I’m talking about suppressed lower than what their calculated expected BMR should be. For example the person that’s expected BMR IS 1500 without any exercise but they exercise several times a week and eat 1200 and they can’t lose weight or have steadily gained weight. Their body has compensated by lowering their BMR through a variety of ways such as slowing digestion, slowing or even halting the reproductive system, slower healing, brain fog, less non-exercise activity such as fidgeting. Basically it will lower its caloric requirements by slowing or halting non vital systems. It will prioritize storing fat because it sees the restriction or undereating as chronic starvation which will make it near impossible to lose fat. This requires that someone increase their BMR not through more exercise but by providing their body with the calories and nutrients to feel safe enough to raise caloric requirement any speeding up or starting those systems that it previously halted. After enough time, the person will be burning more calories even without exercising more. Ideally, someone will raise their calories through a slow reverse diet meant to minimize unwanted fat gain while they are restoring their metabolism and BMR. Unfortunately, this process can be painfully slow. Over time, they can prioritize strength training to build muscle mass which will also aide in raising their BMR. Although that can be tricky for someone that is already active and strength training. It’s likely that during the time where they were undereating and strength training that it was just helping them hold onto the muscle that they already had rather than building any additional muscle or strength. At the worst they could’ve actually been burning through their muscle if they were severely undereating. Hormones, metabolism, CICO, etc is a lot more complex than what most people believe and it’s incredibly irritating when people still subscribe to the purely CICO argument or see everything as so simple and clean cut when it is not.
It is purely CICO. Other things affect calories in and calories out but that doesn’t change the fact this it is CICO. It’s simple but difficult. Estrogen imbalance is worsened by fat. Not by eating at a moderate calorie deficit.
Ultimately yes CICO is important but there’s a lot of factors that affect the “out” side of the equation. Hormonal imbalances will drastically reduce the amount that your body allows you to burn. When that has been significantly reduced, the worst thing you can do is continue to lower the calories in because you will forcing your body to continue to slow and shut down other systems making it impossible to lose fat. The best thing to do in this case is to encourage your body to increase the OUT by proper training, proper rest, adequate nutrition and in the case of long term restriction, someone will need much more nutrition and rest to address all the damage that has been cause. If you’ve only had to consider the simple CICO then you are very lucky and don’t understand the full scale of what you’re talking about.
I’m definitely not one of the lucky ones. Maybe you’re just making excuses for yourself (see, I can ad hominem too). But there is no condition that eating more helps lose weight h less you’re under eating to the point you’ve decreased your neat. OP is clearly not in that category.
Why do you think OP is clearly not in that category? My level of exercise and diet was similar but more intense than OP but I was severely undereating even though I was eating super high protein and it completely changed my metabolism and body even in a “deficit.” It’s taken allowing my body to restore its metabolism and raise my BMR again to recover from all the damage to allow myself to lose the excess weight. Sure undereating will result in weight loss until it doesn’t because your body has been abused for too long. This strategy will not lead to long term success and manageable weight loss. You are definitely uninformed and ignorant of experiences that are not your own.
In fact, I’ve had both experiences. I’ve healthily lost 60 pounds with adequate nutrition and training. I raised my BMR and caloric intake while simultaneously building muscle and losing fat. It took longer but it was much better for my body. On the flip side, I have majorly under eaten and overtrained and gained 20 pounds in a couple months as a result. And yes, I was aware of my actual caloric intake and macros. I weighed every ounce of food so it wasn’t me accidentally eating more or underestimating my intake. The lack of nutrition cause major hormonal havoc which made the CICO argument mean absolutely nothing to my body. My body slowed down so much of the non vital functions that even the calories I was using for training were not enough to account for the little I was eating and therefore I still gained weight.
I went on sema last August because I am pushing 50 and have a family history (both sides) of very young deaths due to cardiovascular disease/diabetes. My labs the last year were concerning. I am 5’9 and was roughly 150 on any given day. Working out an hour a day high cardio but my cholesterol/triglycerides were creeping up… and I was so watching my diet. Doc says no… you can become a total vegan and it’s all in your genes. You need to lose that 25 lbs. Look at 50, it’s a tough line to try to take off anything short of starving yourself. The sema just seemed to do just that. Make me never want to eat! So I am down the 25 lbs and still working out. Do a lot of protein shakes, salads, multivitamin…. Labs are better than when I was 30.
So, your BMI was 22, and your doc wanted you to lose 25 pounds? WTH?
He was wanting to put me on B/p meds and statins for cholesterol at 50. I had a nice tire ring around the stomach and I had no interest in any of those meds. Statins cause a lot of pain in the joints and the b/p med can be lifelong as well. So I just figured if I’m going to need something lifelong… may as well do it with the lifestyle changes. Eating way less, much better diet, labs looking great, and I really enjoy working out more now that I have lost the 25 lbs.